Validity of the European short list of respiratory diseases: a 40-year autopsy study

Eur Respir J. 2015 Apr;45(4):953-61. doi: 10.1183/09031936.00085214. Epub 2014 Oct 30.

Abstract

The predictors of autopsy and the accuracy of European short list (E) codes of respiratory diseases lack recent knowledge. A 10% random sample (n=6811) of inhabitants of Bergen, Norway, aged 20-70 years, was invited to participate in a survey in 1965-1971 (participation rate 83%). By December 31, 2005, 4387 (64%) participants had died and 1163 (27% of the deceased) had been given an autopsy. Causes of death were tuberculosis (E02, 0.2%), lung malignancy (E15, 3.5%), influenza (E38, 0.2%), pneumonia (E39, 6.5%) and chronic lower respiratory diseases (E40, 3.2%). Male sex, early deaths in the surveillance period and E15 were positive predictors of an autopsy examination, whereas old age and E39 were strong negative predictors. Among those referred for a post mortem examination, the cause of death was verified as tuberculosis in 0.3%, lung cancer in 8.1%, acute pneumonia in 2.0% and chronic obstructive lung diseases in 4.9%. Cohen's kappa coefficients (E codes versus autopsy) were 0.91 (95% CI 0.86-0.96) for E15, 0.37 (95% CI 0.20-0.54) for E39 and 0.65 (95% CI 0.54-0.76) for E40. These findings matter when deaths from respiratory diseases are used as end-points in epidemiological association studies and clinical trials.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Autopsy
  • Cause of Death*
  • Confidence Intervals
  • Databases, Factual
  • Europe
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mortality / trends*
  • Norway
  • Predictive Value of Tests
  • Respiratory Tract Diseases / diagnosis
  • Respiratory Tract Diseases / mortality*
  • Respiratory Tract Diseases / pathology*
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Urban Population
  • Young Adult